the insufficient delivery of oxygen and other nutrients to some of the body's cells and inadequate elimination of carbon dioxide and other wastes that results from inadequate circulation of blood. also called shock

unlawfully placing a person in apprehension of immediate bodily harm without his consent.

Assault

lumbar vertebrae

vertebrae of the lumbar spine

Electricity Sources

Power Lines
Live power lines, esp. high voltage behave in unpredictable ways
safety zone = 1 span of the power pole's distance
Do not approach downed wires or anything the wires have come in contact with
Wear proper protective equipment
Helmet
Turnout gear

Assess Airways
Special Considerations

Important to consider spinal precautions
Airway management and spinal immobilization must be performed simultaneously
Consider placing the patient in Recovery Position

Allergic Reaction
Insect Bites & Stings
Initial Assessment

General Impressions
May be present as:
Respiratory distress
Cardio-vascular distress
If anxious and in Distress - call for ALS

May have medical tag

Shock

a condition in which the circulatory system fails to provide sufficient circulation so that every body part can perform its function; also called hypoperfusion.

Paranoia

a delusion (false belief) where the patient believes he is being followed, persecuted, or harmed

Involuntary muscle

muscle that responds automatically to brain signals but cannot be consciously controlled.

Cartilage

Tough tissue that covers the joint ends of bones and helps to form certain body parts such as the ear.

Epi

Drug that helps constrict vessels and relax airways passages, it may be used to counter a severe allergic reaction

incident command system

The standardized incident management concept that has become the standard for on scene management of disasters and MCIs; incident commander, staging unit, transport unit, treatment unit, triage unit

hypopnea

inadequate tidal volume in a breathing patient.

larynx

structure that houses the vocal cords and is located inferior to the pharynx and superior to the trachea

binds and transports oxygen and carbon dioxide

hemoglobin

subcutaneous tissue

tissue, largely fat, that lies directly under the dermis & serves as an insulator of the body

Battery

subjecting a patient to unwanted care and transport can be considered this in the court of law

Fight or Flight Manifestations
Interaction of the endocrine and nervous systems
Resulting in chemical and physical responses

Attach the Regulator/flowmeter to the valve stem after clearing the opening
3 holes on 1 side - larger 1 ( on top) = true opening through which the Oxygen flows
2 smaller holes provide stability to the regulator
Pin-Indexing system - these 2 holes are unique to oxygen cylinders
Above the pins on the inside of the collar is the actual port through which oxygen flows from the cylinder to the regulator
Metal/plastic o-Ring around oxygen port to optimize air seal between collar and valve stem

When the patient is developing shock but the body is still able to maintain perfusion.

EMT-P

Paramedic- An EMT who has training in advanced life support, including IV therapy, pharmacology, cardiac monitoring, and other advanced assessment and treatment skills

Respiratory Quality

Normal or abnormal ( shallow, labored, noisy) character of breathing

laryngectomy

Full or partial removal of a person's larynx

Is alcohol a CNS stimulant or depressant?

CBS depressant

physiology

the study of the function of the living body and its parts.

clammy

a moist, or a cool and moist, condition; a skin condition often characteristic of shock

Require that the cell expend energy, usually in the form of ATP

ACTIVE TRANSPORT

deep

further inside the body & away from the skin

Articular cartilage

a thin layer of cartilage, covering the articular surface of bones in synovial joints

Providing a Coordinated Continuum of Care

4th Phase

Patient receives the necessary definitive specialized care

Pressure Regulators

After the pressure is reduced to a more workable level, the final attachment for delivering the gas to the patient is usually:
A quick-connect female fitting that will accept a quick-connect male plug from a pressure hose or ventilator, or resusitator
A flowmeter that will permit the regulated release of gas measured in L/min

Hypoglycemic Agents - Non-Insulin Type Oral Medications

These medications stimulate the pancreas to produce more insulin = lowers blood glucose levels
Sometimes - these medications may lead to hypoglycemia, esp. when activity and exercise levels are too vigorous or excessive

Puncture Wound

Open wound that tears through the skin and destroys under laying tissues

Left Hemisphere Problems

Aphasia: an inability to produce or understand speech.
Receptive Aphasia: patients who cannot understand speech but can speak clearly.
Expressive Aphasia: patients understand the question but cannot produce the right sounds in order to answer. Only grunts or other incomprehensible sounds emerge.

Mobile radio

A two-way radio that is used or affixed in a vehicle.

Artificial ventilation

Forcing air or oxygen into the lungs when a patient has stopped breathing or has inadequate breathing

informed consent

Consent for treatment that is given by a competent patient based on full disclosure of possible risks and consequences

thoracic spine

the upper back, or the 12 thoracic vertebrae directly inferior to the cervical spine.

cell membrane/plasma membrane is the outer covering that encircles and protects the cell is

selectively permeable, or semipermeable

medial

parts of the body that lie closer to the midline; also called inner structures

_____ is the most reliable indicator of an underlying fracture.

Point tenderness

Nonrebreathing Masks
(Exhaled gas escapes through flapper valve ports, at the cheek area of the mask)

Preferred way to deliver oxygen in prehospital care to patient's experiencing difficulty breathing or showing signs of Hypoxia
Combination mask & reservoir bag system
Oxygen fill the bag
Be sure the reservoir bag is full before placing on the patient
Adjust the flow rate so bag does not fully collapse when the patient inhales (2/3 bag volume or 10 - 15 L/min)

Physiology of the Abdomen
2 Different types of nerves:
Parietal Peritoneum

Parietal peritoneum - supplied by spinal cord nerves that supply skin of abdomen
Perceives same types of sensations (pain, touch, pressure, heat, and cold)
Can easily:
identify
Localize a point of irritation

Arterial Gas Embolism

a condition in which gas bubbles enter the arterial system and cause damage by blocking blood flow to vital organs, most commonly the brain; which most often occurs when air passes through the walls of capillaries and alveoli into the bloodstream; also called "air embolism"

Acute Myocardial Infarction

Condition in which a portion of the myocardium dies as a result of oxygen starvation, often called a heart attack by laypersons

tracheostomy tube

a hollow tube that is inserted into a tracheostomy to allow the patient to breathe.

dorsalis pedis artery

the artery on the anterior surface of the foot b/w the 1st & 2nd metatarsals

Eye Protection (Blood, body fluids)

Glasses - must add removable side shields
Goggles

Paradoxial Motion

Movement of a part of the chest in the opposite direction to the rest of the chest during respiration.

What is a Conductor?

Any substance that allows a current to flow through it.

Steps to Performing the Detailed Physical Exam
Steps 1 - 3

Step 1:
Look at the face for obvious lacerations, bruises, or deformities

Step 2:
Examine the area around the eyes and eyelids

Step3:
Examine the eyes for redness and for contact lenses
Assess the Pupils using a pen light

What does the right ventricle do

The right ventricle pumps blood from the heart to the lungs

Where did the saying "hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter" originate from?

Communications between you and the patient are considered confidential
Cannot be disclosed without permission from the patient or court order
Includes
Patient history
assessment findings
Treatment provided
Diagnosis
Mental or Physical conditions

Syringe, preloaded with medication, that has a spring-loaded device that pushes the needle through the skin when the tip of the device is pressed firmly against the body

lordosis

Abnormal anterior convexity of spine; swayback

xiphoid process

inferior portion of the sternum.

Bronchi

Two main tubes of the trachea

universal precautions

protective measures that have traditionally been developed by the Centers for Disease Control & Prevention (CDC) for use in dealing w/ objects, blood, body fluids, or other potential exposure risks of communicable disease

a positive pressure ventilation device that consists of a bag with a nonrebreather valve and a mask. The bag-valve device is connected to the mask or other airway. The bag is squeezed to deliver a ventilation to the patient.

off-line medical direction

medical policies, procedures, and practices that medical direction has established in written guidelines.

Cranium

Top back and sides of the skull

refers to the conduct or qualities that characterize a practitioner in a particular field or occupation

Professionalism

zygomas

the quadrangular bones of the cheek, articulating w/ the frontal bone, the maxillae, the zygomatic processes of the temporal bone, & the great wings of the sphenoid bone

lateral

pertaining to or entailing a position, office, etc., that is different but equivalent or roughly equivalent in status, as distinguished from a promotion or demotion:

Cause

There must be a reasonable cause and effect
(eg. dropping a patient)

Assess Mental Status
Responsiveness
AVPU
Unresponsive

The patient does not respond spontaneously
The patient does not respond to verbal stimuli
The patient does not respond to painful stimuli
The patient usually have no cough or gag reflex and lack the ability to protect their airway
Assume the worst and treat

What two factors determine Pulse Quality?

Rhythm and Force

Temporal regions of the cranium

Sides of the skull

Inhaled Bronchodilators

medication used to open up bronchioles that are constricted due to respiratory disease such as asthma

Abandonment

Leaving a patient after care has been initiated and before the patient has been transferred to someone with equal or greater medical training.

Coronary Arteries

Blood vessels that supply the muscle of the heart

distal

located away from the trunk of the body and toward the free end of an extremity

midaxillary line

an imaginary line that divides the body into anterior and posterior planes; the imaginary line from the middle of the armpit to the ankle.

right plane

everything to the right of the midline.

Fowlers

Lying on back with upper body elevated 45-60 degrees

exposure control plan

a comprehensive plan that helps employees to reduce their risk of exposure to or acquisition of communicable diseases

fallopian tube

long, slender tube that extends from the uterus to the region of the ovary on the same side, & through which the ovum passes from ovary to uterus

infant

a child during the earliest period of its life, esp. before he or she can walk; baby.

Right to Refuse Treatment

You must assess whether the patient's mental condition is impaired
If impaired:
You cannot assume that the refusal is an informed refusal

Focused Physical Exam
Head, Neck, and Cervical Spine
Step 1

Inspect for abnormalities of the head, neck, and cervical spine
Gently palpate the head and back of the neck for any pain, deformity, tenderness, crepitus, and bleeding
Ask a responsive patient if he/she feels any pain or tenderness
Check the neck for signs of trauma, swelling, or bleeding
Palpate the neck for subcutoneous emphysema, as well as any abnormal lumps or masses

Injury caused by an object that passes through the skin or other body tissue.Classified by velocity or speed of penetrating objectCan cause damage by: Directly from projectile and/or Pressure related damage or capitation

hemopneumothorax

the presence of air and blood in the pleaural space.

Dorsal

Referring to the back of the body or the back of the hand or foot. This is a synonym for posterior.

EMT-B

EMT Basic- an EMT who has training in basic life support, including automated external defibrillation, use of a definitive airway adjunct, and assisting patients with certain medications

Hazardous- Material incident

The release of a harmful substance into the environment

sagittal plane

a vertical plane that is parallel to the midline and divides the body into unequal left and right parts

extension posturing

a posture in which the patient arches the back and extends the arms straight out parallel to the body. A sign of serious head injury. Also called decerebrate posturing.

general adaptation syndrome

the body's 3-stage response to stress. 1st stress causes the body to trigger an alarm response, followed by a stage of rxn & resistance & then recovery or if the stress is prolonged, exhaustion

urinary bladder

a sac behind the pubic symphysis made of smooth muscle that collects & stores urine

SIN Haz Mat Response

saftey, isolate and deny entry, notify fire department

Identify Priority Patients and Make Transport Decisions

Some patients benefit by remaining on scene and receiving continuing care:
Older patients with chest pain - administer nitroglycerin - wait for ALS transport
May need to rendezvous with ALS to hasten transport

minute volume

the amount of air breathed in over the course of one minute (tidal volume * breaths per minute)

Irreversible shock

When the body has lost the battle to maintain perfusion to vital organs. Even if adequate vital signs return, the patient may die days later due to organ failure.

on-line medical direction

Direct orders from a physician to a prehospital care provider given by radio or telephone.

Iliac Crest

On each side of the pelvis, forms the &quot;wings&quot;

Open fracture

any break in the bone in which the overlying skin has been damaged as well

Assessing Common Chief Complaints
Abdominal Pain

Look for trauma to the abdomen or Distention
Palpate the abdomen for tenderness, rigidity, and patient guarding

3 parts of the brain

-The brain stem: controls the most basic functions of the body (breathing, blood pressure, swallowing, and pupil constriction. -The cerebellum: Controls muscle and body coordination. Located just behind the cerebellum. Complex tasks with multiple muscle coordination (standing, walking, writing, etc...). -The cerebrum: divided down the middle into left and right hemispheres. Each controls the activities of the opposite side of the body. Front controls emotion and thought, middle controls touch and movement. The back processes sight.

The critical elements of the infection control plan required by Title 29 Code of federal regulation 1910.1030 are...